Poor areas hit hard in health care switch

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If the cabinet transfers youth care, elderly care and young handicapped benefits (Wajong) to municipalities next year, then those municipalities which have the biggest financial problems will have the most work to do. 

The poorest municipalities already have a deficit of care now. This deficit will grow even larger than average because their communities are made up predominantly of the elderly.

These municipalities are arguing that they are already receiving too little compensation for this, making their worry for future problems very big.

The Volkskrant learned this out of research done in conjunction with the Quallity Institute of Dutch Municipalities (King). Calculations show that many municipal governing boards should be aware that they may not be able to fulfill all tasks that the government transfers onto them.

The scale of the problem is unclear, however. Municipalities have no idea how much care they will have to dispense, how heavy this car is, what the costs will be, and how much money the cabinet will provide them with.

The research compared municipalities on three points: the number of citizens that makes use of the arrangements the government is transferring; the percentage of the population that is elderly; and their financial position.

The government has not yet decided on how the arrangements will pan out exactly, but a test-calculation has been done, which does not bode well for the poorer municipalities. "A homogeneous blanket is going to be laid over The Netherlands, under which everyone gets the same amount of money. While we here in North-East Groningen have to deal with far fewer problems than other municipalities", Thea van der Veen, alderman for finance in Delfzijl says.

The dearth of clarity on this means that new councils made up of mayors and aldermen, which is now being formed, have little to go on. "The cabinet is laying the financial responsibilities with the municipalities", Jantine Kriens, president of the directing council of the VNG thinks.

"On these grounds, municipalities can give insufficient guarantees to clients and care providers. The government can put an end to this uncertainty by not applying the cuts to clients as long as they fall under the transfer tax right", Kriens says.

State secretary for public health, Martin van Rijn, doesn't see the uncertainty. "Municipalities get a budged based on the figures of what is now being spent on the AWBZ (Exceptional Medical Expenses) per municipality. The allocation formula for the years after that are now being researched. We also look at the effects of a large population of the elderly. We keep the results of that in mind with the allocation of the money . I find the discoveries of King and the Volkskrant a worthy contribution for a new allocation model."

The municipalities with the most obstacles are mainly in the north and the east of the country, as well as Zeeuws-Vlaanderen and Zuid-Limburg. The Randstad will have relatively few risks for the new tasks.

According to cabinet plans, all municipalities will have three big tasks to tackle next year. Municipalities will be responsible for elderly care, especially for the elderly that need extra help. Next to that, there is a big emphasis on the "bottom of the job market", bringing together benefits, social workplaces and the regulations for young handicapped. Lastly, municipalities will also get all forms of youth care on their plates, this has already been okayed by the cabinet.

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